Women undergoing major heart and blood vessel surgery face a significantly higher risk of death than men, even when experiencing the same complications, a recent study has found. Published October 16 in JAMA, the research analyzed the medical records of over 863,305 patients who underwent high-risk cardiac and vascular procedures between October 2015 and February 2020.
Although roughly 15% of all patients experienced post-operative complications – including heart attacks, blood clots, kidney failure, pneumonia, and surgical site infections – nearly 11% of women died from those complications, compared to 8.6% of men. The study, led by Dr. Catherine Wagner of the University of Michigan, suggests a systemic issue in how complications are recognized and treated in female patients.
“This suggests that a systemic problem contributes to the under-recognition and under-treatment of post-operative complications in women,” Dr. Wagner stated. The research does not pinpoint specific causes for the disparity, but acknowledges that women tend to be older and have more pre-existing health conditions when undergoing these procedures. However, researchers emphasize these factors do not fully explain the increased mortality rate.
Experts suggest unconscious bias may play a role. Dr. Andrei Churyla, a cardiac surgeon at Northwestern Medical Group in Chicago, noted a tendency to underestimate women’s pain, potentially delaying accurate diagnosis and appropriate treatment. “There’s a tendency to minimize women’s pain, which can delay, or prevent adequate diagnosis and treatment,” he said.
The study builds on previous research, including a 2018 study that indicated women were more likely to die from a heart attack if their doctor was male. Dr. Mario Gaudino, a cardiac surgeon at Weill Cornell Medical Center and New York Presbyterian Hospital, described the new findings as “an alarm signal” regarding disparities in surgical outcomes. He added that a lack of understanding of the female body and reliance on male-based diagnostic criteria contribute to the problem.
Despite a broader trend of feminization within the medical profession, certain specialties, notably surgery, remain male-dominated. According to a report published August 1, 2025, women are now the majority among doctors in France but are underrepresented in hospital leadership positions and higher-paying specialties. The report highlighted that while general practice sees a strong female presence, fields like orthopedics, urology, and vascular surgery continue to be largely populated by men.
However, some progress is being made. Dr. Brittany Zwischenberger, a cardiac surgeon at Duke Health in North Carolina, emphasizes the need for a greater awareness of sex-based differences in treatment. “I think we constantly need to remind ourselves that women are different than men,” she said. “Our current research on sex and gender should hopefully lead to tailored surgical approaches and more personalized post-operative care to reduce disparities.”
